Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Smokers’ unprompted comments on cigarette additives during conversations about the genetic basis for nicotine addiction: a focus group study

Authors: Sydney E. Philpott, Sarah Gehlert, Erika A. Waters

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

Research designed to elicit smokers’ cognitive and affective reactions to information about chemicals that tobacco companies add to cigarettes (“additives”) found that knowledge is limited. However, little is known about smokers’ unprompted thoughts and feelings about additives. Such information could be used to shape future communication efforts. We explored the content and possible functions of spontaneous statements about cigarette additives made by smokers during a study examining reactions to learning about the genetic link to nicotine addiction.

Methods

Adult smokers (N = 84) were recruited from a medium-sized Midwestern city. Focus groups (N = 13) were conducted between April-September 2012. Data were analyzed by 2 coders using thematic analysis.

Results

Comments about cigarette additives arose without prompting by the focus group moderator. Three main themes were identified: (1) discussing additives helped participants navigate the conceptual link between smoking and genetics, (2) additives were discussed as an alternative mechanism for addiction to cigarettes, and (3) additives provided an alternative mechanism by which cigarette smoking exacerbates physical harm. Notably, discussion of additives contained a pervasive tone of mistrust illustrated by words like “they” and “them,” by statements of uncertainty such as “you don’t know what they’re putting into cigarettes,” and by negative affective verbalizations such as “nasty” and “disgusting”.

Conclusions

Participants had distinct beliefs about cigarette additives, each of which seemed to serve a purpose. Although mistrust may complicate communication about the health risks of tobacco use, health communication experts could use smokers’ existing beliefs and feelings to better design more effective anti-smoking messages.
Literature
1.
Rustemeier K, Stabbert R, Haussmann H-J, Roemer E, Carmines E. Evaluation of the potential effects of ingredients added to cigarettes. Part 2: chemical composition of mainstream smoke. Food Chem Toxicol. 2002;40(1):93–104.CrossRefPubMed
2.
Radford EP, Hunt VR. Polonium-210: a volatile radioelement in cigarettes. Science. 1964;143(3603):247–9.CrossRefPubMed
3.
Hartwig A. "Cadmium and cancer." Cadmium: From Toxicity to Essentiality. Dordrecht: Springer; 2013. p. 491-507.
4.
Gibb HJ, Lees PS, Pinsky PF, Rooney BC. Lung cancer among workers in chromium chemical production. Am J Ind Med. 2000;38(2):115–26.CrossRefPubMed
5.
Steenland K, Boffetta P. Lead and cancer in humans: where are we now? Am J Ind Med. 2000;38(3):295–9.CrossRefPubMed
6.
7.
Alpert HR, Agaku IT, Connolly GN. A study of pyrazines in cigarettes and how additives might be used to enhance tobacco addiction. Tob Control. 2016;25(4):444–50.CrossRefPubMed
8.
US Food and Drug Administration. Harmful and potentially harmful constituents in tobacco products and tobacco smoke; established list. Fed Regist. 2012;77(64):20034–7.
9.
Geiss O, Kotzias D. Tobacco, cigarettes and cigarette smoke an overview: Institute for Health and Consumer Protection. Luxembourg: European Commission; 2007.
10.
Brewer NT, Morgan JC, Baig SA, et al. Public understanding of cigarette smoke constituents: three US surveys. Tob Control. 2016;26:592–9. tobaccocontrol-2015-052897.CrossRefPubMedPubMedCentral
11.
Hall MG, Ribisl KM, Brewer NT. Smokers’ and nonsmokers’ beliefs about harmful tobacco constituents: implications for FDA communication efforts. Nicotine Tob Res. 2013;16:343–50. ntt158CrossRefPubMedPubMedCentral
12.
Morgan JC, Byron MJ, Baig SA, Stepanov I, Brewer NT. How people think about the chemicals in cigarette smoke: a systematic review. J Behav Med. 2017:1–12.
13.
Pepper JK, Byron MJ, Ribisl KM, Brewer NT. How hearing about harmful chemicals affects smokers’ interest in dual use of cigarettes and e-cigarettes. Prev Med. 2017;96:144–8.CrossRefPubMed
14.
Moracco KE, Morgan JC, Mendel J, et al. “My first thought was croutons”: perceptions of cigarettes and cigarette smoke constituents among adult smokers and nonsmokers. Nicotine Tob Res. 2016;18(7):1566–74.CrossRefPubMed
15.
Etter J-F. Informing smokers on additives in cigarettes: a randomized trial. Patient Educ Couns. 2007;66(2):188–91.CrossRefPubMed
16.
Wiseman KD, Cornacchione J, Wagoner KG, et al. Adolescents’ and young adults’ knowledge and beliefs about constituents in novel tobacco products. Nicotine Tob Res. 2016;18:1581–7. ntw009CrossRefPubMedPubMedCentral
17.
Siahpush M, McNeill A, Hammond D, Fong G. Socioeconomic and country variations in knowledge of health risks of tobacco smoking and toxic constituents of smoke: results from the 2002 international tobacco control (ITC) four country survey. Tob Control. 2006;15(suppl 3):iii65–70.PubMedPubMedCentral
18.
Byron MJ, Baig SA, Moracco KE, Brewer NT. Adolescents’ and adults’ perceptions of ‘natural’,‘organic’and ‘additive-free’cigarettes, and the required disclaimers. Tob Control. 2016;25:517–20. tobaccocontrol-2015-052560CrossRefPubMed
19.
Elton-Marshall T, Fong GT, Zanna MP, et al. Beliefs about the relative harm of “light” and “low tar” cigarettes: findings from the international tobacco control (ITC) China survey. Tob Control. 2010;19(Suppl 2):i54–62.CrossRefPubMedPubMedCentral
20.
Cummings KM, Hyland A, Giovino GA, Hastrup JL, Bauer JE, Bansal MA. Are smokers adequately informed about the health risks of smoking and medicinal nicotine? Nicotine Tob Res. 2004;6(Suppl_3):S333–40.CrossRefPubMed
21.
O’Connor RJ, Lewis MJ, Adkison SE, Bansal-Travers M, Cummings KM. Perceptions of “natural” and “additive-free” cigarettes and intentions to purchase. Health Educ Behav. 2017;44(2):222–6.CrossRefPubMed
22.
Wakefield M, Miller C, Woodward S. Community perceptions about the tobacco industry and tobacco control funding. Aust N Z J Public Health. 1999;23(3):240–4.CrossRefPubMed
23.
Malone RE, Yerger V, Pearson C. Cigar risk perceptions in focus groups of urban African American youth. J Subst Abus. 2001;13(4):549–61.CrossRef
24.
Morgan MG. Risk communication a mental models approach. Cambridge: Cambridge University Press; 2002.
25.
Waters EA, Ball L, Gehlert S. “I don’t believe it.” acceptance and skepticism of genetic health information among African-American and white smokers. Soc Sci Med. 2017;184:153–60.CrossRefPubMed
26.
Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness, The self-regulation of health and illness behaviour, vol. 1; 2003. p. 42–65.
27.
Cameron LD, Marteau TM, Brown PM, Klein WM, Sherman KA. Communication strategies for enhancing understanding of the behavioral implications of genetic and biomarker tests for disease risk: the role of coherence. J Behav Med. 2012;35(3):286–98.CrossRefPubMed
28.
Waters EA, Ball L, Carter K, Gehlert S. Smokers’ beliefs about the tobacco control potential of “a gene for smoking”: a focus group study. BMC Public Health. 2014;14(1):1.CrossRef
29.
Condit CM, Parrott RL, Bates BR, Bevan J, Achter PJ. Exploration of the impact of messages about genes and race on lay attitudes. Clin Genet. 2004;66(5):402–8.CrossRefPubMed
30.
US Department of Health and Human Services. The health consequences of smoking—50 years of progress: a report of the surgeon general. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. p. 17.
31.
Amos CI, Wu X, Broderick P, et al. Genome-wide association scan of tag SNPs identifies a susceptibility locus for lung cancer at 15q25.1. Nat Genet. 2008;40(5):616–22.CrossRefPubMedPubMedCentral
32.
Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. Thousand Oaks: Sage; 2006.
33.
Bernard HR, Wutich A, Ryan GW. Analyzing qualitative data: systematic approaches. Los Angeles, CA: SAGE publications; 2016.
34.
Dar-Nimrod I, Zuckerman M, Duberstein PR. The effects of learning about one's own genetic susceptibility to alcoholism: a randomized experiment. Genet Med. 2012;15(2):132–8.CrossRefPubMed
35.
French D, Maissi E, Marteau TM. The purpose of attributing cause: beliefs about the causes of myocardial infarction. Soc Sci Med. 2005;60(7):1411–21.CrossRefPubMed
36.
37.
Zucker D, Hopkins RS, Sly DF, Urich J, Kershaw JM, Solari S. Florida's “truth” campaign: a counter-marketing, anti-tobacco media campaign. J Public Health Manag Pract. 2000;6(3):1–6.CrossRefPubMed
38.
DeSantis CE, Siegel RL, Sauer AG, et al. Cancer statistics for African Americans, 2016: progress and opportunities in reducing racial disparities. CA Cancer J Clin. 2016;66(4):290–308.CrossRefPubMed
39.
General US. The health consequences of smoking: 50 years of progress. A report of the surgeon general. Atlanta: US Department of Health and Human Services. Centers for Disease Control and Prevention. Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
Metadata
Title
Smokers’ unprompted comments on cigarette additives during conversations about the genetic basis for nicotine addiction: a focus group study
Authors
Sydney E. Philpott
Sarah Gehlert
Erika A. Waters
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5395-8

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Reproducibility of domain-specific physical activity over two seasons in children

Research article

Factors associated with unmet need for contraception in Mexico: evidence from the National Survey of Demographic Dynamics 2014

Research article

The influence of education on the access to childhood immunization: the case of Spain

Research article

Magnitude of opportunistic diseases and their predictors among adult people living with HIV enrolled in care: national level cross sectional study, Ethiopia

Research article

Digital Media-based Health Intervention on the promotion of Women’s physical activity: a quasi-experimental study

Research article

Characteristics of individuals receiving disability benefits in the Netherlands and predictors of leaving the disability benefit scheme: a retrospective cohort study with five-year follow-up